This post is part of a series of posts that focuses on women’s health that will be published this month. 

Ageing is an unavoidable part of life, and it goes without saying our parents face it sooner than we do. Although it is tempting to resort to supplements and creams to stop the ageing process, it is more important to look at some key aspects of diet and overall lifestyle so can they can enjoy their golden years with vitality and health. 

These recommendations are useful for both men and women, although they are particularly crucial for older women. 

As we age, we lose muscle mass and strength; this process starts as early as our 40s. By the time we hit 80s, we could have lost up to 80% of our muscle mass. In woman, muscle loss is attenuated with menopause. The loss in muscle mass and strength results in profound health consequences, and that includes disability, frailty, increased falls, fatigue and diabetes (by increasing insulin resistance). Particularly in women, this involuntary and age-related muscle loss is also associated with rheumatoid arthritis. 

A healthful diet is directly linked with better muscle strength and performance, especially in older age. Unfortunately, the diet of our older generation in Singapore lacks some keys nutrients – one of them being protein. Furthermore, up to 28% of our elder population is at risk of malnutrition, which exacerbates muscle and strength loss and osteoporosis as well.

The diet of our older generation in Singapore lacks some keys nutrients – one of them being protein. Furthermore, up to 28% of our elder population is at risk of malnutrition, which exacerbates muscle and strength loss and osteoporosis as well.

Simply telling our parents to eat more protein is not enough, they usually have low appetite due to illnesses or depression and have tooth and mouth problems. Loneliness and low disposable income can also contribute to poor diets. 

Here are some tips on how our parents can minimize muscle, bone mass and strength loss. 

Load the Protein

Ensure that all their meals have some source of protein. This includes breakfast, lunch, dinner and snacks as well. Here are some tips:

• Blend the meat or fish and tofu with the porridge/congee
• Serve soft dishes such as steamed egg tofu
• Serve extra peanut gravy/curry 
• Ask them to start their meals by having more dhal and sambar and less of the coconut, mint or tomato chutney 
• Flavour the rice with non-fat evaporated milk instead of coconut milk – it will reduce the amount of saturated fat of the meal and increase its protein content. Here is a recipe: https://www.asiaone.com/health/healthier-choice-recipe-indonesian-fatty-rice-made-lighter 

Not sure what to suggest/offer for snacks? We give you a hand:

• Beancurd with less sugar; 
• Green/red bean soup prepared with less sugar; 
• Low-fat yoghurt with ground nuts and frozen berries (that have been defrosted)
• Fruit (e.g. banana) with peanut butter.
• Offer throughout the day reduced-sugar soy milk or low-fat milk. 
• Besides the traditional soft boiled eggs, offer other egg options such as scrambled eggs – they are easy to eat and digest as well. 
• If she is a fan of chocolate, do a tofu chocolate mouse, check out this recipe: https://eatplant-based.com/chocolate-mousse/

Reduce the effect of osteoporosis

52% of elderly Singaporeans are at risk of osteoporosis. Although it can affect men, women are more susceptible to it.

Osteoporosis prevention should start early into adulthood. Nevertheless, during the golden age, there is a lot that can be done to slow down the disease progression and reduce the risk of fracture.

Keep up with calcium and vitamin D 

Calcium and Vitamin D are two critical nutrients for bone health. Calcium helps with keeping the bones structure and function. Maintaining an adequate intake of calcium will help to slow down bone demineralisation responsible for osteoporosis. The most obvious sources of calcium are dairy products. Older adults need about 1000 milligrams of calcium a day, which translates in 3 servings of dairy products a day (1 serving= 250ml milk; 200g yoghurt, 30g cheese). Soy products can usually be enriched with calcium, specifically soy milk and tau kwa. If your mom prefers soya milk, she only needs to take two glasses of soya milk a day to meet her requirements. You can read more on calcium and other food sources in the HPB website here https://www.healthhub.sg/live-healthy/216/calcium_greater_bone_strength 

Without vitamin D, calcium cannot get absorbed. The best way of ensuring vitamin D levels is through sunlight expose, during its peak from 10 to 3 pm for 5 to 30 minutes. Some foods such as milk and soy milk can be also be enriched with vitamin D. Talk with your dietitian about vitamin D, and if you require a supplement. 

Exercise

Go for daily walks with your mom, walking not only strengthens bones and joints but also helps build muscle. Regular walking may reduce the risk of fractures associated with bone and muscle loss. It also improves cardiovascular health; improves sleep and mood, and supports cognitive health (improving memory, reducing risk of Alzheimer and dementia). It also improves appetite. 

Low Appetite

Low appetite is what most seniors complain about when we asked them to eat more, mostly to eat more protein-rich foods. Walks and other exercises are great to increase appetite but these are not the only strategy.

Be social

Loneliness is a serious issue with our elderly. No one likes to eat alone, especially all our meals every-single-day. Discuss with your mom (and dad) how she feels about joining a daycare or senior club, where she can meet new people and stave off loneliness. https://www.healthhub.sg/a-z/medical-and-care-facilities/8/senior_activity_centre 

Water

60% of our body is made up of water. Water is crucial for essential bodily functions. As we age the feeling of thirst decreases as well. Making us more vulnerable to dehydration and other health issues related to it, such as kidney problems. 

Keep offering water, remind her to take 6 to 8 glasses of water a day. 

Schedule a consultation for your mom with a dietitian for a comprehensive nutritional assessment and to find out how she can improve her health and life at her full potential. 

Summary

Liked what you read? Stay tuned for more!

References:

Greco, E. A., Pietschmann, P., & Migliaccio, S. (2019). Osteoporosis and Sarcopenia Increase Frailty Syndrome in the Elderly. Frontiers in endocrinology, 10, 255. https://doi.org/10.3389/fendo.2019.00255

Health Promotion Board. Osteoporosis. HealthHub 2019; https://www.healthhub.sg/a-z/diseases-and-conditions/19/bonehealth

Health Promotion Board. Recommended Dietary Allowances. HealthHub https://www.healthhub.sg/live-healthy/192/recommended_dietary_allowances

Health Promotion Board. The Drop of Water – 6 reasons to drink water. HealthHub 2020;https://www.healthhub.sg/live-healthy/1358/the-drop-of-life—six-reasons-to-drink-water

National Kidney Foundation. Can Hydration affect your kidneys? NFK https://www.kidney.org/newsletter/can-dehydration-affect-your-kidneys#:~:text=Some%20studies%20have%20shown%20that,lead%20to%20permanent%20kidney%20damage.&text=at%20risk%20for%20kidney%20disease.&text=quiz%20to%20find%20out.,-Take%20the%20quiz&text=Dehydration%20can%20cause%20a%20build,with%20muscle%20proteins%20(myoglobin).

Walston J. D. (2012). Sarcopenia in older adults. Current opinion in rheumatology, 24(6), 623–627. https://doi.org/10.1097/BOR.0b013e328358d59b

Wang, P., Abdin, E., Shafie, S., Chong, S. A., Vaingankar, J. A., & Subramaniam, M. (2019). Estimation of Prevalence of Osteoporosis Using OSTA and Its Correlation with Sociodemographic Factors, Disability and Comorbidities. International journal of environmental research and public health, 16(13), 2338. https://doi.org/10.3390/ijerph16132338